Deficits in Upper-Limb Task Performance in Children With Hemiplegic Cerebral Palsy as Defined by 3-Dimensional Kinematics

Schematic diagrams of (A) frontal and (B) lateral views of marker set used for 3-D kinematic analysis. Abbreviations: A1, acromion top; ASIS, right and left anterior superior iliac spine; C7, cervical vertebra 7; EL, elbow lateral; EM, elbow medial; HM, hand marker; LW, lower-arm wand; S, sacral; SN, sternal notch; UW, upper-arm wand; WL, wrist lateral; WM, wrist medial. Legend: ●, retro-reflective external markers placed on the skin; ○, virtual markers created at the neck, shoulder, and elbow and wrist. Adapted from Mackey et al.²¹ Reprinted with permission.

(A) Schematic diagram of subject completing hand-to-head task. (B) Example of sagittal plane shoulder and (C) example of elbow kinematic graphs for hand-to-head task, with time points used to determine the minimum and maximum ROMs used by each subject during performance of the task shown.

(A) Schematic diagram of subject completing hand-to-mouth task. (B) Example of sagittal plane shoulder and (C) example of elbow kinematic graphs for hand-to-mouth task, with time points used to determine the minimum and maximum ROMs used by each subject during performance of the task shown.

(A) Schematic diagram of subject completing reach task. (B) Example of sagittal plane shoulder and (C) example of elbow kinematic graphs for reach task, with time points used to determine the minimum and maximum ROMs used by each subject during performance of the task shown.

Example of (A) sagittal plane shoulder flexion and (B) elbow flexion kinematic graphs from a child with hemiplegia, comparing the affected upper-limb movement during the unilateral (dotted line) and bilateral condition (solid line) of the reach task. Note there was no change in the ROM achieved by the child when the task was completed bilaterally.